Doctor Name: | LISA ANN OTTERBEIN |
NPI Number: | 1619191756 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSPT |
License Number: | 5501012378 |
Business Practice Address: | 25 Conran Dr Coopersville, MI - 494041366 |
Business Phone Number: | 6169976172 |
Business Fax Number: | 6169976178 |
Mailing Address: | 227 Ann St, COOPERSVILLE |
State: | MI |
Postal Code: | 494041166 |
Phone Number: | 6168902076 |
Fax Number: | |
NPI Enumeration Date: | 04/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501012378 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |